$392.89
Both codes cover closed clavicle fracture care; 23505 is for treatment that includes manipulation, while 23500 is for treatment without it.
On this page
CMS RVU26D · Effective 2026-10-01
23500 Clavicle fracture care Medicare reimbursement rates in Vermont
Reports nonoperative definitive care of a clavicle fracture when the clinician treats it without manipulating or manually repositioning the fracture fragments. Compare 23500 office and facility rates across CMS payment localities in Vermont.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 23500 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$249.05
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$236.15
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic fracture care
About 23500: Closed treatment of clavicle fracture
Reports nonoperative definitive care of a clavicle fracture when the clinician treats it without manipulating or manually repositioning the fracture fragments.
This service covers nonoperative management of a clavicle fracture without manually repositioning the fragments. Care may include assessing alignment, choosing support such as a sling, and providing activity restrictions and follow-up instructions. Orthopedic clinicians commonly provide the treatment in an outpatient clinic or emergency setting, or after referral from another clinician.
Report 23500 when the record supports definitive closed fracture care without manipulation, rather than evaluation alone. Document the affected clavicle, fracture diagnosis, treatment undertaken, and plan for immobilization and monitoring. The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. For procedures performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral treatment reported with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 23500
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.15 · 28%
- Practice expense (office) RVU5.13 · 66%
- Malpractice RVU0.45 · 6%
10.8K
Medicare services in 2024 · #1435 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
23500 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 23515 when the clavicle fracture is treated operatively with internal fixation, rather than by closed care without manipulation.
$266.64
23540 addresses closed treatment of an acromioclavicular dislocation, not a fracture of the clavicle.
Compare 23500 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Vermont →
Office / nonfacility
$249.05
Facility
$236.15
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 23500 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,218
- Code
- 23500
- Physician work
- 2.15
- Practice expense
- 5.13
- Malpractice
- 0.45
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.15 | × 1.000 | 2.1500 |
| Practice expense | 5.13 | × 0.990 | 5.0787 |
| Malpractice | 0.45 | × 0.506 | 0.2277 |
| Total RVUs | 7.4564 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$249.05
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1 |
| Practice expense | 5.13 | 0.99 |
| Malpractice | 0.45 | 0.506 |
(2.15 × 1 + 5.13 × 0.99 + 0.45 × 0.506) × $33.4009 = $249.05
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1 |
| Practice expense | 4.74 | 0.99 |
| Malpractice | 0.45 | 0.506 |
(2.15 × 1 + 4.74 × 0.99 + 0.45 × 0.506) × $33.4009 = $236.15
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
23500 billing questions
When should 23500 be chosen over 23505?
Use 23500 when definitive closed care is provided without manipulating the fracture. Use 23505 when the clinician manipulates the fracture.
Can the evaluation visit be billed separately?
The CMS 90-day global period includes the day-before preoperative visit and related postoperative care. Do not separately report routine care included in that global period.
How is treatment of both clavicles reported?
When both sides are treated, modifier 50 identifies the bilateral procedure; CMS pays it at 150%.
Is an assistant surgeon payable for this service?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this code.
What documentation supports reporting 23500?
Document the clavicle fracture, the side treated, and the definitive closed treatment performed without manipulation, along with the immobilization and follow-up plan.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,21523485,,Revision of collar bone,A,,13.56,9.77,NA,9.77,,2.76,26.09,26.09,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21623490,,Reinforce clavicle,A,,11.86,9.58,NA,9.58,,2.53,23.97,23.97,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21723491,,Reinforce shoulder bones,A,,14.18,10.87,NA,10.87,,3.02,28.07,28.07,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21823500,,Cltx clavicular fx w/o mnpj,A,,2.15,5.13,,4.74,,0.45,7.73,7.34,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,21923505,,Cltx clavicular fx w/mnpj,A,,3.73,7.70,,5.80,,0.81,12.24,10.34,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22023515,,Optx clavicular fx w/int fix,A,,9.45,8.94,NA,8.94,,1.94,20.33,20.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,22123520,,Cltx strnclav dislc w/o mnpj,A,,2.23,5.40,,4.68,,0.47,8.10,7.38,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817